CT Enterography for Surveillance of Anastomotic Recurrence within 12 Months of Bowel Resection in Patients with Crohn's Disease: An Observational Study Using an 8-Year Registry
Korean Journal of Radiology
; : 906-914, 2017.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-191315
Responsible library:
WPRO
ABSTRACT
OBJECTIVE:
To investigate the diagnostic yield and accuracy of CT enterography (CTE) for early (< 12 postoperative months) surveillance of anastomotic recurrence after bowel resection for Crohn's disease (CD). MATERIALS ANDMETHODS:
We analyzed 88 adults (60 males and 28 females; mean age, 31.4 ± 9.6 years) who underwent bowel surgery for CD that created ileocolic anastomosis without enteric stoma, and underwent CTE for surveillance of CD recurrence/aggravation within 12 post-operative months. The CD activity index (CDAI) at the time of CTE was < 150 (i.e., clinically silent) in 51 patients, and ≥ 150 in 37 patients. Diagnostic yields of CTE regarding CD recurrence in the ileocolic anastomosis and extraluminal penetrating complications were determined. CTE-related step-up therapy was recorded. These outcomes were compared between the two CDAI groups after accounting for major risk factors for CD recurrence. In a subgroup of 31 patients who underwent both CTE and ileocolonoscopy within 1 month, CTE accuracy for anastomotic recurrence was assessed using the Rutgeerts scoring as the reference standard.RESULTS:
CTE diagnostic yield was 35.2% (31/88) for the anastomotic recurrence and 9.1% (8/88) for penetrating complications. 20.5% (18/88) of the patients underwent step-up therapy after CTE detection of anastomotic recurrence. These outcomes were not significantly different between CDAI < 150 and CDAI ≥ 150, except that CTE yield for extraluminal penetrating complications was significantly higher in CDAI ≥ 150 (16.2% [6/37] vs. 3.9% [2/51]; multivariable-adjusted p = 0.029). CTE showed 92.3% (12/13) sensitivity and 83.3% (15/18) specificity for anastomotic recurrence.CONCLUSION:
CTE may be a viable option for the early postsurgical surveillance of recurred disease in CD patients.
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Recurrence
/
Crohn Disease
/
Risk Factors
/
Follow-Up Studies
/
Sensitivity and Specificity
/
Observational Study
/
Intestines
Type of study:
Diagnostic study
/
Etiology study
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Observational study
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Prognostic study
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Risk factors
/
Screening study
Limits:
Adult
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Female
/
Humans
/
Male
Language:
English
Journal:
Korean Journal of Radiology
Year:
2017
Document type:
Article